Monday, August 29, 2016

Alone or Loney?

One of the workshops I give talks about social connectedness  and the importance of social contact as we grow older. Social Isolation is an important consideration for many and it is defined as not having as much social interaction as the person desires. Social isolation may lead to loneliness.

Loneliness can be explained as the discrepancy between one's desired relationships and one's actual relationships.

The following is from a study that determined that loneliness is a Predictor of Functional Decline and Death. the authors go on to say that:
The subjective distress of loneliness may be a more important measure of suffering and quality of life rather than objective measures of social isolation. Given the number of health and social issues that health care providers must prioritize, the identification and amelioration of loneliness may seem to be outside of the scope of medical practice. Yet, by separating suffering and distress into medical and nonmedical spheres, health care providers may be missing a key risk factor for poor health.

To quantify the prevalence of loneliness and determine whether older persons who are lonely are at risk for poor health outcomes, the authors used the Health and Retirement Study (HRS), a national, population-based study of community living older adults.

The hypothesis that loneliness may be a risk factor for adverse health outcomes in older persons is supported by previous studies that show that other forms of psychosocial distress lead to adverse health outcomes. For example, several studies link depression to higher risks of disability and mortality. Other studies have shown that measures of social isolation—the number of social contacts and the amount of social engagement—are associated with poor health outcomes.

This issue has been called an “epidemic” but how many old people are lonely is highly questionable. An AARP Foundation study [pdf] published in 2012, was unable to quantify it. What the study said was:

Due to the variations described above and the lack of research with representative samples in general, and comparable representative samples in particular, it is difficult to determine the prevalence of isolation.

So, the authors state it is difficult to determine the prevalence of isolation, then they go on to say:
However, current estimates indicate that isolation could impact up to 17% of Americans aged 50+. (They do not say where these estimates came from, so can this estimate be considered accurate?)

Based on a synthesis of the scientific research, this paper proposes the following unifying definition of isolation:

Isolation is the experience of diminished social connectedness stemming from a process whereby the impact of risk factors outweighs the impact of any existing protective factors.

A person’s lack of social connectedness is measured by the quality, type, frequency, and emotional satisfaction of social ties. Social isolation can impact health and quality of life, measured by an individual’s physical, social, and psychological health; ability and motivation to access adequate support for themselves; and the quality of the environment and community in which they live.

When I talk about social connectedness I talk about the following ways to overcome a sense of loneliness and isolation, but only if the individual is not getting the amount of social connectedness they want. I suggest that people:

Take a class
Join a club
Move to a retirement community
Get a pet

Great advice, so easy to say but for many of us, volunteering takes time, energy and resources we need for other activities. I volunteer, and I love it, but it is not for everyone and I understand that. 

I was never a good student, and many of us have not been in a classroom for over 40 years so going back to class is not easy, I know it would be difficult but I recommend it, but with a caveat,  I was talking to a friend who said, that going to a class is problematic because the teachers always go to fast, or assume some level of knowledge not necessarily present.

Joining a club may seem easy, but it is not always. I know some friends who have joined clubs only to find it difficult to break into the group. Many members of clubs often are not as welcoming as they could be, so many of us who are introverts find it difficult to join in and after a few sessions drop out.

People who live in Retirement communities love the lifestyle and enjoy themselves, but for many of us we find it difficult to “give up our independence” so moving is not an option.

Pets live a long time, my last pet lasted 19 years, at my age I may only last 15 years, so why would I take on the responsibility of a pet, when I know that the pet may outlive me and if it does, who will care for the pet.  Pets become part of your family and are loved and cared for and give great pleasure, but they are your love, not your children’s love

Alone not lonely, many of us I believe may be alone, but we are not lonely. There is a wonderful children’s poem that speaks to the idea that we need to spend time with ourselves, it is called:

THE SECRET PLACE, written by Dennis Lee From: The Ice Cream Store. Toronto: Harper Collins Publishers, 1991.

There's a place I go, inside myself,
          Where nobody else can be,
And none of my friends can tell it's there—
          Nobody knows but me.

It's hard to explain the way it feels,
          Or even where I go.
It isn't a place in time or space,
          But once I'm there, I know.

It's tiny, it's shiny, it can't be seen,
          But it's big as the sky at night . . .
I try to explain and it hurts my brain,
          But once I'm there, it's right.

There's a place I know inside myself,
          And it's neither big nor small,
And whenever I go, it feels as though
          I never left at all.

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